百樂眠膠囊聯合艾司西酞普蘭片治療失眠伴抑郁焦慮的臨床效果

張東子　陳亞蘭　劉建叢

[摘要] 目的 探討百樂眠膠囊聯合艾司西酞普蘭片治療失眠伴抑郁焦慮的臨床效果。 方法 選取2016年2月～2018年4月河北大學附屬醫院收治的失眠伴抑郁焦慮患者143例。根據隨機數字表法分為對照組（n = 71）和研究組（n = 72），對照組給予艾司西酞普蘭片治療，研究組則在對照組基礎上聯合百樂眠膠囊治療。比較兩組患者治療2個月后臨床效果，比較兩組患者治療前、治療2個月后漢密爾頓焦慮量表（HAMA）、漢密爾頓抑郁量表（HAMD）、匹茲堡睡眠質量指數（PSQI）、血清神經肽Y（NPY）、P物質（SP），記錄兩組患者治療期間不良反應發生情況。 結果 研究組患者治療后總有效率顯著高于對照組（P < 0.05）。兩組患者治療2個月后HAMA、HAMD及PSQI均較治療前降低，且研究組低于對照組（P < 0.05）。兩組患者治療2個月后血清NPY水平較治療前升高，且研究組高于對照組（P < 0.05），SP水平較治療前降低，且研究組低于對照組（P < 0.05）。研究組治療期間不良反應總發生率低于對照組（P < 0.05）。 結論 百樂眠膠囊聯合艾司西酞普蘭片治療失眠伴抑郁焦慮，效果確切，可有效改善患者臨床癥狀，改善患者血清NPY、SP水平，且能有效降低不良反應發生率。

[關鍵詞] 百樂眠膠囊;艾司西酞普蘭片;失眠伴抑郁焦慮;臨床研究

[中圖分類號] R740? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2019）06（b）-0133-04

Clinical effect of Bailemian Capsules combined with Escitalopram Tablets in the treatment of insomnia with depression and anxiety

ZHANG Dongzi1? ?CHEN Yalan2? ?LIU Jiancong3

1.Psycho-Counseling Clinics， Affiliated Hospital of Hebei University， Hebei Province， Baoding? ?071000， China; 2.Department of Digestive Internal Medicine， Affiliated Hospital of Hebei University， Hebei Province， Baoding? ?071000， China; 3.The Third General Internal Medicine， Hebei Sixth People′s Hospital， Hebei Province， Baoding? ?071000， China

[Abstract] Objective To investigate the clinical effect of Bailemian Capsules combined with Escitalopram Tablets in the treatment of insomnia with depression and anxiety. Methods From February 2016 to April 2018， 143 cases of insomnia patients with depression and anxiety admitted to the Affiliated Hospital of Hebei University were selected. According to the random number table method， they were divided into the control group （n = 71） and the research group （n = 72）. The control group was treated with Escitalopram Tablets， while the research group was treated with Bailemian Capsules on the basis of the control group. The clinical effects of the two groups were compared after 2 months of treatment， compared two groups of patients Hamilton anxiety scale （HAMA） and Hamilton depression scale （HAMD）， Pittsburgh sleep quality index （PSQI）， serum neuropeptide Y （NPY） and substance P （SP） were compared before and after 2 months treatment， adverse reactions during treatment were recorded in both groups. Results The total effective rate of the study group was significantly higher than that of the control group （P < 0.05）. HAMA， HAMD and PSQI of the two groups were decreased after 2 months of treatment compared with those before treatment， and the study group was lower than the control group （P < 0.05）. After 2 months of treatment， the serum NPY level in the two groups was higher than that before treatment， and the level of SP in the study group was lower than that in the control group （P < 0.05）. The total incidence of adverse reactions during treatment in the study group was lower than that in the control group （P < 0.05）. Conclusion Bailemian Capsules combined with Escitalopram Tablets for the treatment of insomnia with depression and anxiety has an accurate effect， which can effectively improve the clinical symptoms of patients， improve the serum NPY and SP levels of patients， and effectively reduce the incidence of adverse reactions.

[Key words] Bailemian Capsules; Escitalopram Tablets; Insomnia with depression and anxiety; Clinical study

睡眠是人體正常生理活動之一，通過充足的睡眠，可使機體疲勞的神經細胞恢復至正常的生理狀態[1]。然而，當機體具備足夠的睡眠時間以及適宜的睡眠環境，卻依舊無法正常入睡時，則造成失眠現象[2]。長期失眠可誘發一些心身疾病，例如心動過速、消化性潰瘍、抑郁焦慮情緒等[3]。其中失眠伴抑郁焦慮癥狀表現最為明顯，既往相關研究[4]表明，約高達50%的失眠患者并發抑郁焦慮情緒。艾司西酞普蘭片是臨床常用于治療抑郁焦慮情緒的藥物，具有一定的治療效果，然而長期使用易產生藥物依賴性，患者依從性差[5]。近年來，中醫藥在治療失眠伴抑郁焦慮取得了較大進展，百樂眠膠囊是治療失眠的中成藥，且無藥物依賴性[6]。……